EMERGENCY FUNCTION OF SUPRARENAL MEDULLA 181 



the cava segment were tied. The pocket thus formed was allowed to fill 

 with blood from the suprarenal veins, and this blood was either allowed 

 to pass into the general circulation by removal of the clamp on the in- 

 ferior cava, or was withdrawn and tested outside the body on prepara- 

 tions of rabbit uterus and intestine. The arrangement was modified in 

 the "permanent pocket" by tying splanchnic vessels and shutting off the 

 blood flow in the hind quarters. Experiments performed under these con- 

 ditions revealed a spontaneous liberation of epinephrin, which- was un- 

 changed in amount by sciatic stimulation or asphyxia. A number of con- 

 ditions pertinent to this method and its results are worthy of consideration'. 



1. It has long been known that opening the abdomen is attended by 

 splanchnic nervous discharges which inhibit the -movements of the stom- 

 ach and intestines (Bayliss and Starling). Only when these disturbing 

 consequences of operation are eliminated do' the movements occur. The 

 blood vessels of the mesenteries also become. constricted (Henderson) ; in- 

 deed, there is evidence of general vasoconstriction, splanchnic and somatic, 

 in consequence of abdominal section and intestinal manipulation (Erlanger, 

 Gesell and Gasser). In other words, all parts of the abdominal viscera, 

 vascular and gastro-intestinal, are specially innervated by the splanchnics 

 when the abdomen is opened and its contents handled. In view of the 

 typically diffuse distribution of sympathetic impulses, it is highly improb- 

 able, to say the least, that the fibers supplying the suprarenal medulla are 

 alone excluded from increased activity. In a number of cases of low rate of 

 the denervated heart not yet published, the rate has been seen to go up 

 promptly when the abdomen was opened. 



2. In a series of cases reported by Cannon (e) (1919), sciatic stimula- 

 tion and primary asphyxia, in cats under urethane anesthesia, were usu- 

 ally ineffective in accelerating the isolated heart, if the abdomen had been 

 opened and the mesentery denervated. Stewart and Rogoff(tf) (w) (1920) 

 report that they have had no difficulty in causing acceleration of the de- 

 nervated heart after opening the abdomen. It may be that the depth of 

 anesthesia is, in addition to laparotomy, an important factor in checking 

 reflex effects, for recently Cannon and Rapport have been able, after 

 opening the abdominal cavity, to cause commonly acceleration of the de- 

 nervated heart by sciatic stimulation, if light ether anesthesia was main- 

 tained. There is some question, however, whether the conditions of Stew- 

 art and RogofFs experiments permitted the abdominal reflexes involving the 

 suprarenal glands, that would be present in animals with abdomen intact. 



3. In some of their experiments with use of the cava pocket, Stewart 

 and Regoff have reported blood pressures. These pressures have fallen 

 in different cases as low as 40, 29, and even 20 mm. Hg (1916(&) ). As is 

 well known, abdominal operations and repeated opening of the abdominal 

 cavity are likely to be attended by a failing circulation. It is noteworthy 

 that the blood flow into the pocket, in cases where no blood pressure has been 



